337 Neonatal Outcome in Triplet Pregnancies

Abstract

Background in the last 10 years, advances in the induction of ovulation (OI) and assisted reproductive techniques (GIFT, FIVET, ICSI) have resulted in an epidemic of multiple pregnancies. Unfortunately, the increase in twin and higher-order gestations has also increased maternal and perinatal risks. Data from recent literature try to point-out differences in obstetric and neonatal outcomes in spontaneus multiple pregnancies versus pregnancies obtained with OS or assisted procreation. The aim of this study is to evaluate and compare spontaneous vs non-spontaneous neonatal outcomes of triplet pregnancies in the Policlinic A. Gemelli, a reference centre for high risk pregnancies.Methods We studied 24 triplet pregnancies, 6 spontaneous, 7 obtained with OI and 11 obtained with assisted procreation techniques. All 72 newborns were evaluated for: prematurity, neonatal weight, IUGR, birth weight discordance, need for resuscitation at birth, and major neonatal diseases (infective, hematologic, respiratory, cardiovascular, malformative and neurologic).Results Spontaneous and non-spontaneous triplet pregnancies had similar EG and neonatal weight: EG 33±1 weeks vs 33±2 weeks, neonatal weight 1705±256 g vs 1907±452. There were no significative differences in IUGR and birth weight discordance (>20%) and in major neonatal diseases. Among non-spontaneous triplets we observed 2 malformative diseases (a polimalformative syndrome and a cri-du-chat syndrome), 2 neurologic diseases (IVH 2 grade), 1 cardiovascular disease (surgically treated PDA) and 1 feto-fetal transfusion.Conclusions Our results confirm literature data about absence of significative neonatal outcome differences between spontaneous and non-spontaneous triplet pregnancies, but individual clinics and collaborative efforts are needed to extend the number of observations about major neonatal diseases (expecially malformative).